The United States, Puerto Rico, and many islands in the Carribean have recently faced an immense amount of destruction thanks to mother nature. Several hurricanes and tropical storms have devastated many areas, causing destruction to communities, widespread power-outages, and quite possibly, drug shortages.
How could this cause a shortage?
Around 10% of drugs prescribed in the United States are manufactured in Puerto Rico. Pharmaceutical companies like Eli Lilly, Pfizer, and Baxter are just a few of the many manufacturers that have facilities located in Puerto Rico.
In response to these natural disasters, the FDA Commissioner, Scott Gottlieb, M.D., issued a statement regarding the potential for drug shortages. According to the FDA Commissioner, the pharmaceutical industry is responsible for nearly 90,000 jobs and for 72.4% of Puerto Rico’s 2016 exports totaling $14.5 billion.
You can read more of this statement here.
What drugs have been affected?
The types of medications and medical products produced in Puerto Rico include HIV and cancer drugs, immunosuppressants used by organ transplant patients, diabetes devices, and even hospital IV bags.
What is being done to address the shortages?
In order to address current and future problems, the FDA has been working with pharmaceutical companies to create a task force to prioritize efforts and address the potential for medical product shortages.
According to the American Society of Health-System Pharmacists (ASHP) the FDA is tracking 40 critical medications — 12 that are not produced outside of Puerto Rico — that are at risk of being in short supply because of hurricane-related manufacturing delays.
While there are no shortages yet, a small number may appear in the next couple of weeks. Stay tuned, we will keep you updated!
Asthma can feel different for everyone affected by it. For some people, allergies and various environmental allergens play a major role in the severity of their asthma. For others, triggers like perfume or exercise can lead to breathing problems.
If you have asthma, your doctor will most likely prescribe you a controller inhaler as well as a rescue inhaler. Controller or maintenance inhalers like Symbicort, Advair, and Flovent are used regularly to decrease the inflammation and swelling in the lungs associated with asthma. Rescue inhalers, on the other hand, are used to open your airways immediately when you’re having an asthma attack. These include Proair, Proventil, and Ventolin.
Using your maintenance inhaler regularly can help lessen the frequency and severity of asthma attacks—but many people aren’t using their maintenance inhalers correctly.
To help keep more people on track, a company called Adherium has recently received FDA clearance for their SmartTouch sensor. The sensor will only be used with AstraZeneca’s Symbicort inhaler for now.
What is SmartTouch?
SmartTouch is a device installed onto a an inhaler that will monitor and encourage adherence (taking your prescription as intended) as part of a self-management plan.
What is it meant to do?
According to the press release from Adherium, it’s common for patients with respiratory conditions, like asthma, to take only 30 – 50% of their prescribed medications! And believe it or not, they aren’t alone. The World Health Organization (WHO) notes that on average, 50% of folks suffering from chronic illnesses do not take their medications as prescribed. What’s the downside? It can be outright dangerous, with consequences including (obviously) your condition getting worse, but also increased costs, and even death.
How does SmartTouch work?
The SmartTouch device records the date and time the inhaler is used and automatically sends the info to an app on your phone or tablet.
It stores the history of your usage patterns, which also lets your doctor review the information and help make evidence-based decisions on how to best to meet your needs.
How is the device used?
SmartTouch is placed over the Symbicort inhaler—it’s designed to make installation and removal easy for everyone.
The SmartTouch design includes three buttons that help you easily access the audio-visual reminders, battery monitoring, and bluetooth pairing features.
How will SmartTouch help me?
According to Adherium, the SmartTouch can improve adherence by up to 59% in adults and 180% in children. That increased adherence was also associated with a 60% decrease in severe respiratory episodes in adults.
Is there already anything like SmartTouch out there already?
There are a couple of similar devices made by other companies, including CareTRx (previously known as GeckoCap, and recently purchased by TEVA pharmaceuticals) and Propeller Health (partnered with Boehringer Ingelheim).
Adherium also makes two otherdevices for inhalers (SmartTurbo and SmartTouch AV), but neither have been approved by the FDA for use in the US yet.
These price increases, among others, have shed necessary light on price hiking and transparency, and have caused many states to take this matter into their own hands. At the moment, 23 states are stepping up their efforts on drug pricing by proposing bills that take on the rising cost of drug pricing.
What is drug pricing transparency?
First off, it’s great for your pocketbook. Drug pricing transparency would require pharmaceutical companies and middlemen (like pharmacy benefit managers) to be less secretive about the actual costs of their medications.
Who would benefit?
Essentially everyone, minus those with a hidden agenda. Providing drug pricing will ensure affordable and accessible prescription drugs for consumers.
What’s going on in California?
Exciting things! Governor Jerry Brown just signed the SB-17 drug transparency bill. This bill requires that pharmaceutical companies give the state of California 60 days notice anytime they plan to raise the price of a drug by 16% or more over 2 years. The companies would also have to explain why the increases are necessary. In addition, health insurers would have to report what percentage of premium increases are caused by drug spending.
California also has another bill, AB-265, which would prohibit drug companies from offering coupons and other discounts to brand-name drugs that have an alternative cheaper generic available. This bill has yet to get to the governor but has passed in the Senate.
Vermont passed a bill in 2016 that requires pharmaceutical companies to provide justification for drug price hikes.
Each year the Green Mountain Care Board in collaboration with the Department of Vermont Health Access identifies drugs that have experienced price hikes by 50% or more over the past five years, or by 15% more over the past 12 months. For drugs that have experienced increases, the state can fine the pharmaceutical companies.
What about Nevada?
In June, Nevada passed a bill that focuses solely on the cost of diabetes medications. However, it is currently facing lawsuits from pharmaceutical lobbying groups, as they claim that it is unconstitutional and possibly violates patient rights. More to come on this!
What’s going on with the bill in Ohio?
The Ohio Drug Price Act is an initiative that aims to cut pricing. Or does it?
This act would mandate that the state agencies pay no more for prescription drugs than the U.S Department of Veterans Affairs, which typically gets a 24% discount on the price of drugs from pharmaceutical companies.
However, this bill does not apply to those with private health insurance; therefore, if passed Ohioans insured through their employers could actually see drug prices go up in order for the drug companies to regain the money lost from selling to certain buyers at a lower rate. A similar bill in California flopped just last year!
It seems like more bills are being proposed every day. Stay tuned, we will keep you in the loop.
Nasal polyps are common in people with allergies and asthma. Treatment has included nasal sprays and oral medications, and now we have a new one to add to the list, Xhance (fluticasone propionate).
What is Xhance indicated for?
Xhance is a corticosteroid indicated for the treatment of nasal polyps in patients 18 years of age or older. It will be available as a nasal spray in the strength of 93 mcg.
The recommended dose of Xhance is one or two sprays per nostril twice daily. The Xhance delivery system is called the Optinose delivery system. It works to help deliver Xhance deep into the nasal cavity. Be sure to read the instructions before using the delivery system.
Who is at risk for nasal polyps?
Any condition that causes chronic inflammation in the nasal passages or sinus area may increase your risk of developing nasal polyps. The following conditions can put you at a higher risk for nasal polyps: asthma, aspirin sensitivity, allergic fungal sinusitis, cystic fibrosis and Churg-Strauss syndrome.
What are the common side effects associated with Xhance?
Common side effects include nosebleeds, nasal septal ulceration, nasopharyngitis, nasal mucosal erythema, nasal mucosal ulcerations, nasal congestion, acute sinusitis, nasal septal erythema, headache, and pharyngitis. Be sure to speak with your doctor if you experience any of these symptoms for a prolonged period of time.
- The strength of Xhance is 93 mcg per spray whereas the strength of Flonase is 50 mcg per spray.
- Xhance is indicated for the treatment of nasal polyps whereas Flonase is indicated for the management of allergy symptoms.
- Xhance requires a prescription whereas Flonase can now be purchased over-the-counter without a doctor’s prescription.
- Flonase is available in a generic version, as fluticasone propionate, whereas Xhance is only available as a brand name medication.
The importance of getting a flu shot can’t be overstated, especially for those who are at a higher risk like young children, pregnant women, older adults, and the immunocompromised or disabled. (If you’re living or traveling outside the US, you’re also at higher risk.)
Before the various types of flu shot we have now—quadrivalent, nasal spray, high-dose, and more—there was only one option when it came to protecting yourself from the yearly flu. Now, you have options, and there are ways to get vaccinated even if you’re allergic to eggs, worried about preservatives, or just don’t like needles.
If you’re worried about cost, know that flu shots can range from $0 (yes, free) to $50 or more, depending on where you get your shot and what kind of vaccine you receive. Whether you’re insured or not, there are ways to make your family’s vaccines affordable.
For this year’s flu season, the experts have some new recommendations. We’ll also show you how to save no matter where you’re getting your shot.
ACIP recommends nasal spray flu vaccine should not be used (again)
The CDC’s panel of experts known as the Advisory Committee on Immunization Practices (ACIP) voted again this year that the nasal spray flu vaccine known as FluMist should not be used for the 2017-2018 flu season.
For the first time last year, the ACIP recommended against the use of the nasal flu vaccine. There are concerns about how effective it was against flu viruses in the US in previous years.
Scared of needles? Intradermal flu vaccines are your best bet
With the nasal spray option off the table, consider an intradermal flu shot. The intradermal shot uses a small, ultra-thin needle that’s 90% smaller than the ones used for other flu shots. The intradermal vaccine is given through your skin (intradermal) where the regular shot is given into the muscle (intramuscular).
Currently, Fluzone Intradermal is the only small-needle flu shot available.
Keep in mind—you can get your flu shot and a shingles vaccine together
The FDA now has substantial data showing that getting a flu shot and shingles vaccine at the same time is perfectly fine. The shingles vaccine, also known as Zostavax, is used for the prevention of shingles in adults 50 years of age and older.
Make sure to get your flu shot early
It can take up to 2 full weeks before you’re fully protected after you get your shot. It’s always best to get vaccinated and make sure you’re protected as early in the flu season as possible, before you may be exposed to others who have the flu. However, this is especially important if you plan to travel this fall—make sure to plan ahead and get your shot more than 2 weeks ahead of time so you’re protected once you hit the road (or the air).
If you’re pregnant, or thinking about becoming pregnant, get the flu vaccine
The flu vaccine is recommended if you will be pregnant during flu season (as early as October through as late as May). A flu shot can be given at any time during pregnancy, before and during flu season.
Your child may need 2 doses of the flu vaccine
If your child is 6 months to 8 years old, evidence from several studies shows that they require 2 doses of the flu shot (given at least 4 weeks apart) during their first season of vaccination for optimal protection.
Children 6 months through 8 years who have previously received 2 or more total doses of flu vaccination (trivalent or quadrivalent, it doesn’t matter) before July 1, 2017 will need only 1 dose this year.
You must be a certain age to receive a high-dose flu shot
You may not have to go to your doctor—or even your pharmacy
Flu vaccine accessibility continues to get better. You can still get a flu shot (and other vaccines) from your doctor, or your pharmacy—but many people are getting vaccinated at clinics, health departments, at school or a community center, and even through employers.
If you do prefer to get your flu shot from your doctor, check with the office first to see if they have the current flu vaccinations available for the 2017-2018 flu season, and ask if you’ll need an appointment.
Use these resources help you figure out where to get your shot
First, check GoodRx for discounts at flu shot prices at pharmacies in your area!
The HealthMap vaccine finder is also great tool for finding where to get vaccinated. Their site allows you to search by location, and to see a list of places near you that have the shot available. Make sure to call ahead whether you see your pharmacy on the list or not. And if you don’t see your local pharmacy, don’t be discouraged, they may still offer flu shots.
Flu shots can be expensive . . .
Flu vaccines start at about $20, and can cost more than $50 per shot, if you’re paying out of pocket with no discount or insurance. You’ll pay more if you’re getting one of the less common varieties like the high-dose shot or the nasal spray.
Medicare Part B completely covers flu shots—if you have Part B, your shot should be free. Commercial insurance plans often cover flu shots at no cost to you, because they are considered preventive care. One exception: if you get a shot from your doctor, you may still have to pay for the office visit.
. . . But there are lots of ways to save
Around this time of year, there are an abundance of free clinics and events offering low-cost or free flu shots across the US. Watch for announcements on your local news station, or in the local newspaper—or search online for free flu shots in your area. These are often very specific to your area, so keep an eye out.
Many pharmacies also have a flat rate for flu shots, or offer discounts or other perks if you get vaccinated at their stores. There are fewer offers out there than in previous years, but a few examples include:
- CVS offers a coupon for $5 off a $25 purchase when you get a flu shot. CVS doesn’t offer discounts on the vaccination itself, but they do note that your shot will most likely be free if you have any kind of insurance.
- Costco has shots starting at $19.99 (and a great list of tips on how to prepare for your shot.)
- Walgreens doesn’t offer a discount, but they do have a “give a shot, get a shot” program. When you get vaccinated at Walgreens, they will provide a vaccine to a child in need.
- Walmart also offers flu shots starting at $39.84.
Most pharmacies started receiving their shipments for the 2017-2018 flu shots in August, so go get vaccinated!